Care Pathway Effect on In-Hospital Care for ST-Elevation Myocardial Infarction.

Abstract:

OBJECTIVES:To study the care pathway effect on the percentage of patients with ST-elevation myocardial infarction -(STEMI) receiving timely coronary reperfusion and the percentage of STEMI patients receiving optimal secondary prevention. METHODS:A care pathway was implemented by the Collaborative Model for Achieving Breakthrough Improvement. One pre-intervention and 2 post-intervention audits included all adult STEMI patients admitted within 24 h after onset and eligible for reperfusion. Adjusted (hospital random intercepts and controls for transfer and out-of-office admission) differences in composite outcomes were analyzed by a multilevel logistic regression. RESULTS:Significant improvements in intervals between the first medical contact (FMC) to percutaneous coronary intervention (PCI) and between the door to PCI were shown between post-intervention audit II and post-intervention audit I. Secondary prevention significantly deteriorated at post-intervention audit I but improved significantly between both post-intervention audits. Six out of nine outcomes were significantly poorer in the case of transfer. The interval from FMC to PCI was significantly poorer for patients admitted during out-of-office hours. CONCLUSIONS:After care pathway implementation, composite outcomes improved for in-hospital STEMI care. Collaborative efforts exploited heterogeneity in performance between hospitals. Iterative and incremental care pathway implementation maximized performance improvement.

journal_name

Cardiology

journal_title

Cardiology

authors

Aeyels D,Bruyneel L,Sinnaeve PR,Claeys MJ,Gevaert S,Schoors D,Panella M,Sermeus W,Vanhaecht K

doi

10.1159/000488932

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

163-174

issue

3

eissn

0008-6312

issn

1421-9751

pii

000488932

journal_volume

140

pub_type

杂志文章,多中心研究
  • Predictors of coronary dissection following percutaneous transluminal coronary balloon angioplasty.

    abstract::To determine predictors of acute coronary dissection after coronary angioplasty, we studied 170 consecutive patients who underwent arterial dilatations of 234 arteries. Coronary dissection occurred in 103 (44%) arteries. More dissections occurred in women [40/73 (55%) versus 63/161 (39%), p < 0.03] and in patients wit...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000176680

    authors: Ilia R,Bigham H,Brennan J,Cabin H,Cleman M,Remetz M

    更新日期:1994-01-01 00:00:00

  • Left ventricular function during asynchronous ventricular pacing: a radionuclide study.

    abstract::This study was undertaken to assess ventricular volumes and function by radionuclide angiography during asynchronous ventricular pacing in a group of 22 patients who needed an artificial pacemaker. 14 had ischaemic heart disease and 8 had primary disturbances of conduction of the impulse-forming system. The transition...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000173685

    authors: Weiss AT,Gotsman MS,Lewis BS,Rein AJ,Atlan H

    更新日期:1984-01-01 00:00:00

  • Recurrent preexcited reciprocating tachycardia, concealed ventricular preexcitation and conduction disturbances in the normal atrioventricular pathway in a newborn.

    abstract::We describe a newborn infant with concealed ventricular preexcitation in sinus rhythm on the early ECGs, and who developed recurrent episodes of preexcited reciprocating tachycardia. Manifestation of the ventricular preexcitation and initiation of the tachycardias were dependent on the presence of severe conduction di...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000173991

    authors: Belhassen B,Pardo J,Peled B,Blieden L,Laniado S

    更新日期:1986-01-01 00:00:00

  • Comparison of Quality of Life Perceived by Patients with Bioprosthetic versus Mechanical Valves after Composite Aortic Root Replacement.

    abstract:OBJECTIVE:To assess whether postoperative quality of life (QOL) for composite aortic root replacement patients differs according to whether it is based on the use of mechanical valves or bioprosthetic valves. METHODS:The study included 146 consecutive patients who underwent composite aortic root replacement at our ins...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000438783

    authors: Repack A,Ziganshin BA,Elefteriades JA,Mukherjee SK

    更新日期:2016-01-01 00:00:00

  • Arrhythmogenic right ventricular cardiomyopathy: the challenge of genetic interpretation in clinically suspected cases.

    abstract::This is the case of a 43-year-old Caucasian man with frequent episodes of paroxysmal atrial fibrillation (AF) and normal resting electrocardiogram (ECG), who fulfilled two minor diagnostic criteria for arrhythmogenic right ventricular cardiomyopathy (ARVC): late potentials by signal-averaged ECG and regional right ven...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000342274

    authors: Anastasakis A,Vouliotis AI,Protonotarios N,Stefanadis C

    更新日期:2012-01-01 00:00:00

  • Efficacy and safety of clopidogrel 600 mg administered pre-hospitally to improve primary percutaneous coronary intervention in patients with acute myocardial infarction (CIPAMI): study rationale and design.

    abstract::Clopidogrel, in combination with acetylsalicylic acid, has become a mainstay of the pharmacological therapy for patients with acute coronary syndromes, especially in those undergoing percutaneous coronary interventions (PCI). While a series of studies has shown that pre-treatment with a loading dose of clopidogrel 300...

    journal_title:Cardiology

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1159/000096988

    authors: Zeymer U,Arntz HR,Darius H,Huber K,Senges J

    更新日期:2007-01-01 00:00:00

  • Muscle fiber disarray in patients without hypertrophic cardiomyopathy.

    abstract::Muscle fiber disarray (MFD) has been described as the histologic feature of hypertrophic cardiomyopathy (HC), but it was also found in normal and other abnormal conditions. Its distribution related to the topography of the myocardium has not been described. In this paper, the incidence of MFD in hearts free from HC, t...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000173850

    authors: Milei J,Migliore R,Guerrero F,Pedroza C,Storino R

    更新日期:1985-01-01 00:00:00

  • Prognostic value of ischemia monitoring with on-line vectorcardiography in patients with unstable coronary artery disease.

    abstract:AIM:The aim of this study was to determine whether on-line vectorcardiography (VCG) gives independent prognostic information, regarding death, myocardial infarction (MI), and revascularization in patients with unstable coronary artery disease, i.e. unstable angina or non-Q-wave MI. METHODS AND RESULTS:One hundred and ...

    journal_title:Cardiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1159/000007024

    authors: Lundin P,Jensen J,Lindahl B,Wallentin L,Eriksson SV

    更新日期:2000-01-01 00:00:00

  • A Simplified Two-Stepwise Electrocardiographic Algorithm to Distinguish Left from Right Ventricular Outflow Tract Tachycardia Origin.

    abstract:BACKGROUND:There are several electrocardiographic algorithms to predict the origin of idiopathic outflow tract ventricular arrhythmias (OT-VAs). This study aimed to develop a more accurate and efficient stepwise electrocardiographic algorithm to discriminate left ventricular outflow tract (LVOT) from right ventricular ...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000507360

    authors: Yu M,Li X,Zhang H,Xia Y,Liu J,Fang P

    更新日期:2020-01-01 00:00:00

  • The Dual Antiplatelet Therapy Trial after the FDA Update: Noncardiovascular Deaths, Cancer and Optimal Treatment Duration.

    abstract:BACKGROUND:The landmark Dual Antiplatelet Therapy (DAPT) trial revealed an impressive reduction of stent thrombosis and myocardial infarction after prolonged 30-month DAPT compared to the conventional 12-month regimen. However, aside from the expected extra bleeding risks, more cancers and noncardiovascular deaths (NCV...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000431356

    authors: Serebruany VL,Cherepanov V,Golukhova EZ,Kim MH

    更新日期:2015-01-01 00:00:00

  • Does age have an effect on the time of occurrence of cardiac arrest of presumed cardiac etiology? Belgian Cardiopulmonary-Cerebral Resuscitation Study Group.

    abstract::To assess possible age-related differences in the time of occurrence (hour of the day, day of the week, month of the year) of cardiopulmonary collapses of presumed cardiac etiology, 3,305 out-of-hospital patients registered by the Belgian Cardiopulmonary-Cerebral Resuscitation Study Group between 1983 and 1990 were st...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000176873

    authors: Martens P,Calle P,Hubloue I,Van den Poel B,Lewi P

    更新日期:1995-01-01 00:00:00

  • Effect of body characteristics on the variables of signal-averaged electrocardiogram in healthy teenage subjects.

    abstract::Ventricular late potentials are obtained by signal-averaged surface electrocardiography. Late potentials have been reported to be affected by body characteristics or left ventricular mass. To evaluate late potentials in relation to body characteristics, 52 healthy Japanese young volunteers (21 girls, 31 boys) aged 15-...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000175950

    authors: Iwasaka T,Usui H,Masui A,Tamura K,Sugiura T,Karakawa M,Inada M

    更新日期:1993-01-01 00:00:00

  • Left atrial passive emptying function is preserved in patients with permanent atrial fibrillation--a 320-slice multidetector computed tomography study.

    abstract:OBJECTIVE:Left atrial (LA) mechanical function is thought to be virtually inexistent in patients with permanent atrial fibrillation (AF). Due to recent advances in multidetector computed tomography (MDCT) technology, it is now possible to acquire images of the entire heart in a single heartbeat. The objective of this s...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000365915

    authors: Agner BF,Kühl JT,Kofoed KF,Engstrøm T,Jensen GB,Dixen U

    更新日期:2014-01-01 00:00:00

  • Grade III ischemia on presentation with acute myocardial infarction predicts rapid progression of necrosis and less myocardial salvage with thrombolysis.

    abstract::We assessed the relation between baseline electrocardiographic ischemia grades and initial myocardial area at risk (AR) and final infarct size (IS) in 49 patients who had undergone (99m)Tc sestamibi single-photon emission computed tomography before and 6 +/- 1 days after thrombolysis. Patients were classed as having g...

    journal_title:Cardiology

    pub_type: 临床试验,杂志文章

    doi:10.1159/000063334

    authors: Birnbaum Y,Mahaffey KW,Criger DA,Gates KB,Barbash GI,Barbagelata A,Clemmensen P,Sgarbossa EB,Gibbons RJ,Rahman MA,Califf RM,Granger CB,Wagner GS,AMISTAD (Acute Myocardial Infarction Study of Adenosine) Investigators.

    更新日期:2002-01-01 00:00:00

  • Evaluation of the exercise test in patients with angiographically documented coronary artery disease.

    abstract::100 male patients with at least 75% obstruction of one or more coronary arteries were subjected to submaximal exercise tests. Among the 73 subjects who had positive tests, 92% of those with one-vessel obstruction had an ST depression of 1 mm, none having more than 2 mm; by contrast, 44% of those with three-vessel dise...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000169871

    authors: Friedmann J,Agmon J,Cherbakoff A,Aygen M,Wurzel M

    更新日期:1977-01-01 00:00:00

  • Galectin-3 Induces Atrial Fibrosis by Activating the TGF-β1/Smad Pathway in Patients with Atrial Fibrillation.

    abstract:BACKGROUND:Atrial fibrosis plays a critical role in the occurrence and maintenance of atrial fibrillation. The role of TGF-β1 in mediating atrial fibrosis is well documented. The β-galactoside-binding lectin galectin-3 (Gal-3) is mainly produced by macrophages in biological events such as inflammation and angiogenesis....

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000506072

    authors: Xiao M,Zhang M,Bie M,Wang X,Guo J,Xiao H

    更新日期:2020-01-01 00:00:00

  • Left ventricular function in patients with chronic obstructive pulmonary disease.

    abstract::We assessed the left ventricle function in 24 patients with severe (forced expiratory volume in 1 sec less than 50% of predicted) chronic obstructive pulmonary disease (COPD) and in 21 normal people. We measured the left ventricular systolic time intervals (STI) and echocardiographic left ventricular diameters, volume...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000173231

    authors: Louridas G,Patakas D,Stavropoulos C

    更新日期:1981-01-01 00:00:00

  • Non-invasive measurement of cardiac output during atrial fibrillation: comparison between cardiac magnetic resonance imaging and inert gas rebreathing.

    abstract:OBJECTIVES:Atrial fibrillation (AF) is one of the most frequent heart rhythm disorders. It potentially influences cardiac function and its measurement. Cardiac magnetic resonance imaging (CMR) has become the new gold standard for non-invasive assessment of cardiac output (CO). A novel inert gas rebreathing (IGR) device...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000288712

    authors: Saur J,Trinkmann F,Doesch C,Weissmann J,Hamm K,Schoenberg SO,Borggrefe M,Haghi D,Kaden JJ

    更新日期:2010-01-01 00:00:00

  • Myocardial angiogenesis resulting in functional communications with the left cavity induced by intramyocardial high-frequency ablation: histomorphology of immediate and long-term effects in pigs.

    abstract::A previous study in rabbit hearts demonstrated the feasibility of creating transmyocardial channels by application of temperature-regulated high-frequency (HF) energy. Feasibility of creating non-transmural channels using a transvascular approach was tested in 14 pigs which were followed for 1 h, and 3 and 9 weeks (gr...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000068450

    authors: Dietz U,Horstick G,Manke T,Otto M,Eick O,Kirkpatrick CJ,Meyer J,Darius H

    更新日期:2003-01-01 00:00:00

  • Percutaneous transluminal coronary angioplasty in unstable and stable angina pectoris: a comparison of immediate success and complications.

    abstract::To determine the success rate and the safety of percutaneous transluminal coronary angioplasty in patients with unstable angina pectoris (group 1) versus stable angina (group 2), we studied 299 consecutive patients who underwent coronary angioplasty of 373 consecutive lesions. Of these patients, 149 had unstable angin...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000175811

    authors: Ilia R,Kolansky D,Setaro J,Brennan J,Cabin H,Cleman M,Remetz M

    更新日期:1992-01-01 00:00:00

  • ACP1 genetic polymorphism and coronary artery disease: an association study.

    abstract:OBJECTIVES:Assuming an immune component in the pathogenesis of atherosclerosis, we have investigated a possible association between coronary artery disease (CAD) and the acid phosphatase locus 1 (ACP1) genetic polymorphism, which has previously been found to be associated with immune disorders. METHODS:226 subjects ad...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000203405

    authors: Banci M,Saccucci P,D'Annibale F,Dofcaci A,Trionfera G,Magrini A,Bottini N,Bottini E,Gloria-Bottini F

    更新日期:2009-01-01 00:00:00

  • Exercise training in mild hypertension: effects on blood pressure, left ventricular mass and coagulation factor VII and fibrinogen.

    abstract::The aim of this study was to assess the effects of aerobic exercise on resting and 24-hour blood pressure (BP), left ventricular mass (LVM), plasma fibrinogen and factor VII (FVII). For this purpose 14 sedentary subjects with untreated diastolic BP between 90 and 104 mm Hg completed a 12-week supervised exercise progr...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000177378

    authors: Zanettini R,Bettega D,Agostoni O,Ballestra B,del Rosso G,di Michele R,Mannucci PM

    更新日期:1997-09-01 00:00:00

  • Low lymphocyte ratio as a novel prognostic factor in acute heart failure: results from the Pre-RELAX-AHF study.

    abstract:BACKGROUND:Previous studies have suggested that a lower lymphocyte ratio (Ly%) in the white blood cell (WBC) differential count is related to worse outcomes in patients with acute heart failure (AHF) and other cardiovascular disorders. METHODS:In the Pre-RELAX-AHF study, 234 patients with AHF, systolic blood pressure ...

    journal_title:Cardiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1159/000321416

    authors: Milo-Cotter O,Teerlink JR,Metra M,Felker GM,Ponikowski P,Voors AA,Edwards C,Weatherley BD,Greenberg B,Filippatos G,Unemori E,Teichman SL,Cotter G

    更新日期:2010-01-01 00:00:00

  • Use of programmed stimulation in identifying patients at high risk for sudden cardiac death.

    abstract::Sudden cardiac death accounts for 60% of the total cardiovascular mortality in the United States. Individuals after myocardial infarction or with chronic left ventricular dysfunction are known to be at increased risk. Noninvasive studies have been applied to these populations, but the predictive accuracy of these test...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000174604

    authors: Hessen SE,Nydegger CC,Kutalek SP

    更新日期:1990-01-01 00:00:00

  • Chest pain and behavior in suspected coronary artery disease.

    abstract::This study assessed behavioral activity, dietary and emotional variables among patient cohorts with angina pectoris, atypical chest pain, and no chest pain in whom coronary disease is suspected. Questionnaire responses of 3,899 employed male patients at the time of coronary arteriography were analyzed. Patients with a...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000174344

    authors: Young LD,Barboriak JJ,Anderson AJ

    更新日期:1988-01-01 00:00:00

  • Fibrosis of collagen I and remodeling of connexin 43 in atrial myocardium of patients with atrial fibrillation.

    abstract:BACKGROUND:Fibrosis in atrial myocardium is a common phenomenon for patients with atrial fibrillation (AF). Remodeling of connexins was found accompanying with AF. The aim of the study is to investigate whether it is by causing the remodeling of connexin 43 (Cx43) that the fibrosis of atrial muscle plays an important r...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000095501

    authors: Luo MH,Li YS,Yang KP

    更新日期:2007-01-01 00:00:00

  • Discontinuation of antihypertensive therapy: prevalence of relapses and predictors of successful withdrawal in a hypertensive community.

    abstract::Antihypertensive therapy has been thought to be a life-long treatment. Nevertheless, antihypertensive medication may be discontinued in a substantial proportion of hypertensive patients at least for some time. The current study focused on predictors for the development of elevated blood pressure levels after discontin...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000177343

    authors: Schmieder RE,Rockstroh JK,Gatzka CD,Rüddel H,Schächinger H

    更新日期:1997-05-01 00:00:00

  • Coronary reperfusion for the treatment of acute myocardial infarction: postischemic ventricular dysfunction.

    abstract::There has been recent interest in treating acute myocardial infarction with coronary reperfusion by fibrinolytic therapy. Experimental studies have shown that myocardial infarct size can be reduced by coronary reperfusion. However, return of cardiac function, high energy phosphate metabolism, and cardiac ultrastructur...

    journal_title:Cardiology

    pub_type: 杂志文章,评审

    doi:10.1159/000173600

    authors: Kloner RA,Ellis SG,Carlson NV,Braunwald E

    更新日期:1983-01-01 00:00:00

  • Efficacy and safety of imidapril in patients with essential hypertension: a double-blind comparison with captopril.

    abstract::In this 12-week, double-blind, parallel-group, comparative trial, 57 adult patients with mild-to-moderate hypertension were randomly allocated to receive imidapril or captopril, initially at a dose of 5 mg once a day and 25 mg twice daily, respectively. After 4 weeks of therapy, the dose of each drug was increased twi...

    journal_title:Cardiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1159/000047361

    authors: Huang PJ,Chien KL,Chen MF,Lai LP,Chiang FT

    更新日期:2001-01-01 00:00:00

  • Prevalent Diabetes Mellitus: Mortality and Management in Norwegian Heart Failure Outpatients.

    abstract:OBJECTIVES:Heart failure (HF) patients with diabetes mellitus experience poor prognosis. We assessed the independent predictive effect of prevalent diabetes mellitus on all-cause mortality in HF outpatients. Furthermore, we investigated if optimized HF medication differed in diabetic versus nondiabetic patients. METHO...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000444658

    authors: Stubnova V,Os I,Grundtvig M,Waldum-Grevbo B

    更新日期:2016-01-01 00:00:00